Basic Information
| Provider Information | |||||||||
| NPI: | 1245215870 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DUNITZ | ||||||||
| FirstName: | NEAL | ||||||||
| MiddleName: | ALLAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D., C.M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7755 CENTER AVE | ||||||||
| Address2: | STE 630 | ||||||||
| City: | HUNTINGTON BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 926479152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6572372450 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 395 OYSTER POINT BLVD STE 512 | ||||||||
| Address2: | |||||||||
| City: | SOUTH SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940801973 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6508262945 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 03/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | G49187 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD19131 | OR | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 068564 | 05 | OR | MEDICAID | 8212961 | 01 | WA | WASHINGTON MAP NUMBER | OTHER | 288287 | 01 | OR | OMAP BILLING NUMBER | OTHER |